A new, simple maxillary‐sparing tongue depressor for external mandibular radiotherapy: A case report

Bodard, Anne-Gaëlle; Racadot, S.; Salino, Samuel; Pommier, P.; Zrounba, Philippe; Montbarbon, X.

doi:10.1002/hed.21047

Cited by 22 publications

(29 citation statements)

References 4 publications

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“…Although many authors have reported the benefits of using an intraoral stent to ensure consistent reproducibility of patient positioning during radiation therapy, few have been able to quantify the stability. Lopatta et al and Baumert et al conducted clinical trials to measure the effects of intraoral stabilization on the reproducibility of patient positioning throughout the course of radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical reports have described the fabrication of repositioning stents using acrylic resin . Only 2 studies have attempted to assess the influence of an intraoral repositioning stent on reproducibility of patient positioning; however, unlike the current study, in that study, intraoral stents were attached to extraoral frameworks .…”

mentioning

confidence: 96%

“…Clinical reports have described the fabrication of repositioning stents using acrylic resin. 5,8,[10][11][12][13] Only 2 studies have attempted to assess the influence of an intraoral repositioning stent on reproducibility of patient positioning; however, unlike the current study, in that study, intraoral stents were attached to extraoral frameworks. 14,15 As a result, the current feasibility study was conducted to determine if a newly proposed stent design can provide clinically acceptable stability of patient po-…”

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confidence: 99%

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The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

Lee

Nguyen

2019

Journal of Prosthodontics

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Purpose Radiotherapy is one of the main treatment modalities for head and neck cancers. To minimize damage to normal tissues during radiotherapy, various methods of stabilization have been used, including thermoplastic facemasks and repositioning stents. The goal is to assess the effect of using a customized oral repositioning stent on patient positioning during the course of radiotherapy. Materials and Methods Ten consecutive patients scheduled to undergo intensity modulated radiation therapy (IMRT) for cancers of the maxillary sinus, nasal cavity, or oral cavity were recruited to participate in the study (ST group). These patients were matched to 2 retrospective cohorts, one using the original repositioning stent design (OB group), and the other with no stabilization stent (NB group). Hard baseplate wax was used to create a customized wax pattern of the proposed acrylic stent chairside, and processed in heat‐cured clear hard acrylic. Relative stability of the daily patient setup was assessed by comparing measurements from surrogate bony landmarks to radiation isocentres obtained from the initial reconstructed planning computed tomograph (CT) to each daily KeV image. Results There was no stent fracture or distortion throughout treatments, and no patients’ treatments were required to be aborted, delayed, or replanned. Mean 3D deviations for the ST, OB, and NB groups were 0.29 ± 0.10 cm, 0.32 ± 0.14 cm, and 0.31 ± 0.13 cm, respectively. The ANOVA test revealed no significant difference in triangulated variations between the treatment groups (F = 0.18, p = 0.84). Patient stability data demonstrated mean vertical, longitudinal, and lateral variations that did not appear different when compared to 2 retrospective cohorts. Although the deviations were not statistically significant between matched cohorts, the added durability of the stent and comfort for patients, without affecting IMRT timeline, are considered clinically significant. Conclusion By using a customized repositioning stent, it is possible to maintain patient stability comparable to prior protocols and within the range of clinical guidelines, while providing superior comfort and ease of insertion to the patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 96%

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confidence: 99%

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The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

Lee

Nguyen

2019

Journal of Prosthodontics

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“…2a,b). Besides, its production is safe, easy to fabricate and comfortable to wear [58][59][60]. Recent studies have investigated the use of this device with the intention of minimizing the adverse effects of radiation, including osteoradionecrosis, oral mucositis and xerostomia [57][58][59][60][61].…”

Section: Intraoral Stentmentioning

confidence: 99%

“…Some authors indicate their use only during tongue cancer radiation therapy [59][60][61]; whereas others show them to be of benefit in tumors located in the floor of the mouth [58] and nasopharyngeal [62]. In Verrone et al [58] opinion, this device must be referred to in all tumor cases that present healthy contralateral structures (maxilla or mandible) that need to be spared from dose irradiation with no reduced effect in the prescribed dose to the target volume.…”

Section: Intraoral Stentmentioning

confidence: 99%

Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

et al. 2017

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Xerostomia or dry mouth is one of the most common and disturbing adverse effects following radiotherapy for head and neck cancer (HNC). This complication strongly increases the risk for dental caries, difficulties with chewing, swallowing and sleep disorders with significant impact on patients' quality of life. Current treatment approaches of xerostomia are often difficult and bring in many cases no substantial relief for the patient. This paper discusses the clinical features and current knowledge of xerostomia prevention in order to evaluate the real possibilities of reducing the incidence and severity of this complication in HNC patients. Salivary gland cytoprotectants (amifostine), muscarinic agonist stimulation (pilocarpine and bethanechol), salivary gland-sparing radiation technique (intensity-modulated radiotherapy-IMRT), surgical relocation of the submandibular gland, intraoral stent and stem cell transplantation are promising techniques that are discussed in this study.

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Impact of intraoral stent on the side effects of radiotherapy for oral cancer

et al. 2012

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A new, simple maxillary‐sparing tongue depressor for external mandibular radiotherapy: A case report

Abstract: The realization is simple and cheap, the apparatus is comfortable, and modifications are easy. It can be used in all patients, except in patients with totally mandibular edentulous with severe bone resorption.

Cited by 22 publications

References 4 publications

The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

Impact of intraoral stent on the side effects of radiotherapy for oral cancer

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